DOI: 10.1002/alz.078729 ISSN: 1552-5260

Associations between psychological risk and protective profiles and cognitive status in two independent cohorts

David Bartrés‐Faz, Harriet Demnitz‐King, Cristina Solé‐Padullés, Rob Saunders, Gabriele Cattaneo, María Cabello‐Toscano, Olga M Klimecki, Javier Solana Sánchez, Josep Mª Tormos‐Muñoz, Gael Chetelat, Alvaro Pascual‐Leone, Natalie L Marchant
  • Psychiatry and Mental health
  • Cellular and Molecular Neuroscience
  • Geriatrics and Gerontology
  • Neurology (clinical)
  • Developmental Neuroscience
  • Health Policy
  • Epidemiology



Positive and negative psychological factors represent pertinent moderators of relative risk and protection for cognitive decline and dementia. For example, repetitive negative thinking has been associated with accelerated cognitive decline and AD pathology1, whereas self‐reflection and purpose in life have been related to better cognition and cognitive resilience2,3. Existing studies predominately focus on individual factors, thus it is unknown whether psychological profiles, combining risk and protective features, are differentially associated with cognitive function.


Individuals without objective cognitive impairment were included from two European studies: the middle‐aged Barcelona Brain Health Initiative (N = 741) 4 and the older‐adult Medit‐Ageing (N = 279)5,6 cohorts. Self‐report questionnaires to assess levels of psychological risk and protective factors were completed and global cognitive assessments obtained in both studies (Table 1). Latent Profile Analysis (LPA) was performed on psychological questionnaire data to identify statistically different groups of individuals in each cohort separately. ANCOVA (adjusting for age, sex, and education), were then conducted to compare different psychological profiles according to cognitive status.


LPA identified a three‐class solution in both cohorts (Table 1 and Figure 1): “low levels of psychological protective factors” (class‐1), “high levels of psychological risk factors” (class‐2), and “average levels of psychological risk and protective factors” (class‐3). In both cohorts, psychological profile membership was significantly associated with cognition. Specifically, individuals with low levels of psychological protective factors had worse global cognitive function compared with individuals with other profiles (BBHI: F:6.05, p<0.002; Medit‐Ageing: F:7.99, p<0.001; Figure 2).


Individual psychological risk and protective factors aggregated into three identifiable psychological profiles that were evident across two independent cohorts. In both cohorts, having a psychological profile with low levels of protective factors rather than high levels of risk factors, was associated with worse global cognitive function. Such observations may have implications for future, more personalized, application of psychological therapies contributing to dementia prevention.

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